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LIFESTYLE PLUS PRODUCT RANGE

Products designed for you

CLAIM VALIDATION QUESTIONS

Please answer the following questions and attach your supporting documentation (as either a photo and/or document) where required.

Select the product you wish to claim against

Policy Number

First Name

Is your claim due to an injury or illness?

Last Name

Were you overseas when the injury or illness first occurred?

DOB

Is your injury or illness due to a pre-existing condition?

Pre-existing condition definition:

Have you been signed off by your treating doctor/specialist as being incapacitated for more than 7 days?

What's the current end date you've been signed off?

Do you have a medical certificate?

Please attach your medical certificate

Photo

Max 15MB

Doc

Max 15MB

Please provide a brief description of the circumstances surrounding your injury or illness

MAINTENANCE COSTS

Swimming Pool Maintenance

Garden Maintenance

House Cleaning

Washing and/or Ironing

Meal Delivery

Petcare

Childcare

Photo

Max 15MB

Photo

Max 15MB

Photo

Max 15MB

Photo

Max 15MB

Photo

Max 15MB

Photo

Max 15MB

Photo

Max 15MB

Photo

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

PREPAID EXPENSES

Event Ticket(s)

Accommodation

Experience(s)

Endurance Event(s)

Lesson(s)

Course(s)

Photo

Max 15MB

Photo

Max 15MB

Photo

Max 15MB

Photo

Max 15MB

Photo

Max 15MB

Photo

Max 15MB

Photo

Max 15MB

Photo

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

RECURRING EXPENSES

Gym Membership

Sports Club Membership

Mobile Phone Plan

Lesson(s)

Course(s)

Photo

Max 15MB

Photo

Max 15MB

Photo

Max 15MB

Photo

Max 15MB

Photo

Max 15MB

Photo

Max 15MB

Photo

Max 15MB

Photo

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

DAMAGED ITEMS

Jewellery

Clothing

Eyewear

Head/Earphones

Camera

Laptop/Tablet

Personal Transport Device

Sports Equipment

Mobile Phone

School Equipment

Mobility Aid

Hearing Aid

Dentures

Photo

Max 15MB

Photo

Max 15MB

Photo

Max 15MB

Photo

Max 15MB

Photo

Max 15MB

Photo

Max 15MB

Photo

Max 15MB

Photo

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

MISCELLANEOUS EXPENSES

Taxi/Rideshare Charges

Personal Trainer

Motor Vehicle Excess

Replacement Keys/Locks

Replacement Cards/Identification

Hospital Expenses

Relative Flowers

Photo

Max 15MB

Photo

Max 15MB

Photo

Max 15MB

Photo

Max 15MB

Photo

Max 15MB

Photo

Max 15MB

Photo

Max 15MB

Photo

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

EDUCATIONAL EXPENSES

Daycare/Preschool Fees

Student Home Tutorial

School Incursions/Excursions

Photo

Max 15MB

Photo

Max 15MB

Photo

Max 15MB

Photo

Max 15MB

Photo

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

PARTNERS PEACE OF MIND

Accidental Death

Permanent Disability

Coma

Please continue to click on any category to claim against the required benefit(s)

OVERSEAS EXPENSES

Travel Insurance Excess

Room Service

Extra Leg Room

Photo

Max 15MB

Photo

Max 15MB

Photo

Max 15MB

Photo

Max 15MB

Photo

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

Doc

Max 15MB

What is the total amount you are claiming?

Name of Bank

Name of Account Holder

BSB

Account number

Email

Phone

I acknowledge that I have answered all questions truthfully and the information provided is a true and accurate representation and no information has been witheld.

Your claim has been submitted succesfully. An email confirmation has been sent to your nominated email address!

IMPORTANT INFORMATION

Complaints Resolution

Privacy Statement

Financial Hardship

Family and Domestic Violence

Customer Vulnerability

Transalation and Interpreting Service

Duty of Disclosure

Financial Service Guide (FSG)

Website Terms and Conditions

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© 2023 Future Insurance Group International (ABN 68 619 183 149 AFSL 506558)

Future Insurance Group International (FiGi Life) ABN 68 619 183 149 AFSL 506558. FiGi Life has arranged this insurance which is issued and managed by Agile Underwriting Service Pty Limited (ABN 48 607 908 243, AFSL 483374 (“Agile”) an agency acting on behalf of the insurer Certain Underwriters at Lloyd’s. Terms, conditions, limits and exclusions apply. Any advice provided is general only and may not be right for you. To decide if the insurance is right for you please carefully read the Product Disclosure Statement (PDS) (which includes the terms and conditions of cover), Target Market Determination (TMD) and Financial Services Guide (FSG).

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